Drug addiction is a
treatable disorder. Through treatment that is tailored to individual
needs, patients can learn to control their condition and live normal,
Like people with
diabetes or heart disease, people in treatment for drug addiction
learn behavioral changes and often take medications as part of their
treatment regimen.Behavioral therapies can include counseling, psychotherapy, support
groups, or family therapy. Treatment medications offer help in suppressing the withdrawal
syndrome and drug craving and in blocking the effects of drugs.In general, the more treatment given, the better the results.Many patients require other services as well, such as medical and
mental health services and HIV prevention services. Patients who stay in treatment longer than 3 months usually have
better outcomes than those who stay less time.Patients who go through medically assisted withdrawal to minimize
discomfort but do not receive any further treatment, perform about the
same in terms of their drug use as those who were never treated.
Over the last 25 years, studies have shown that treatment works to
reduce drug intake and crimes committed by drug-dependent people.
Researchers also have found that drug abusers who have been through
treatment are more likely to have jobs.
Types of Treatment Programs
The ultimate goal of all drug abuse treatment is to enable the
patient to achieve lasting abstinence, but the immediate goals are to
reduce drug use, improve the patient's ability to function, and
minimize the medical and social complications of drug abuse.
There are several types of drug abuse treatment programs.
Short-term methods last less than 6 months and include residential
therapy, medication therapy, and drug-free outpatient therapy. Longer
term treatment may include, for example, methadone maintenance
outpatient treatment for opiate addicts and residential therapeutic
community treatment.Outpatient drug-free treatment does not include medications and
encompasses a wide variety of programs for patients who visit a clinic
at regular intervals.Most of the programs involve individual or group counseling.Therapeutic communities (TCs) are highly structured programs in
which patients stay at a residence, typically for 6 to 12 months.
Patients in TCs include those with relatively long histories of drug
dependence, involvement in serious criminal activities, and seriously
impaired social functioning. The focus of the TC is on the
resocialization of the patient to a drug-free, crime-free lifestyle.Short-term residential programs, often referred to as chemical
dependency units, are often based on the "Minnesota Model" of
treatment for alcoholism. These programs involve a 3- to 6-week
inpatient treatment phase followed by extended outpatient therapy or
participation in 12-step self-help groups, such as Narcotics Anonymous
or Cocaine Anonymous.
Drug treatment programs in prisons can succeed in preventing
patients' return to criminal behavior, particularly if they are linked
to community-based programs that continue treatment when the client
leaves prison. Some of the more successful programs have reduced the
rearrest rate by one-fourth to one-half. For example, the "Delaware
Model," an ongoing study of comprehensive treatment of drug- addicted
prison inmates, shows that prison-based treatment including a
therapeutic community setting, a work release therapeutic community,
and community-based aftercare reduces the probability of rearrest by
57 percent and reduces the likelihood of returning to drug use by 37
Behavioral Change Through Treatment
from the disease of drug addiction is often a long-term process,
involving multiple relapses before a patient achieves prolonged
behavioral therapies have been shown to help patients achieve initial
abstinence and maintain prolonged abstinence.
frequently used therapy is cognitive behavioral relapse prevention in
which patients are taught new ways of acting and thinking that will
help them stay off drugs.
example, patients are urged to avoid situations that lead to drug use
and to practice drug refusal skills. They also are taught to think of
the occasional relapse as a "slip" rather than as a failure.
Cognitive behavioral relapse prevention has proven to be a useful and
lasting therapy for many drug addicted individuals.
One of the more well-developed behavioral
techniques in drug abuse treatment is contingency management, a system
of rewards and punishments to make abstinence attractive and drug use
unattractive.Ultimately, the aim of contingency management
programs is to make a drug-free, pro-social lifestyle more rewarding
than a drug-using lifestyle.The community reinforcement approach is a
comprehensive contingency management approach that has proven to be
extremely helpful in promoting initial abstinence in cocaine addicts.Once drug use is under control, education and job rehabilitation
Rewarding lifestyle options must be found for people
in drug recovery to prevent their return to the old environment and
way of life.